Physician Compare National (NPI:1225316953)

HEALTHCARE PROVIDER: KATIE LYNN PHILLIPS O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1225316953
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375716848
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161129000242
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PHILLIPS
	Individual professional last name
Provider First Name	KATIE
	Individual professional first name
Provider Middle Name	LYNN
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3200 JOHN WILLIAMS BLVD
	Group Practice or individual's line 1 address
City	BEDFORD
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	474219153
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8122771275
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y